Provider Demographics
NPI:1649639113
Name:ARKANSAS BAPTIST CHILDREN'S HOMES
Entity type:Organization
Organization Name:ARKANSAS BAPTIST CHILDREN'S HOMES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LITTLE ROCK AREA DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPC
Authorized Official - Phone:501-455-8554
Mailing Address - Street 1:PO BOX 30022
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72260-0001
Mailing Address - Country:US
Mailing Address - Phone:501-455-8554
Mailing Address - Fax:
Practice Address - Street 1:12400 INTERSTATE 30 STE 201
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72210-7032
Practice Address - Country:US
Practice Address - Phone:501-455-8554
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-12
Last Update Date:2016-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP1210096251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health